Senior Credentialing and Clinician Onboarding Manager
Description
Senior Credentialing and Clinician Onboarding Manager
About the role: Oversee the operations of the Mindful Health Solutions clinician credentialing process. Responsible and accountable for systems and processes that ensure providers are properly licensed and credentialed when they begin work. This individual will oversee initial and ongoing application process for all clinicians maintaining the organization’s credentialing databases and online systems, up-to-date credential files, and managing all health plan enrollments and reappointments for both delegated and none delegated authority.
Benefits
• Comprehensive medical, dental, vision & pet insurance
• 401(k) with 4% match
• Equipment provided
• 18-days of PTO + 1 floating holiday
Responsibilities:
• Overall responsibility for ensuring that Clinicians are fully onboarded and credentialed by day one of their clinical work schedules by project managing the end-to-end process and various cross-functional parties involved
• Monitors and reports turnaround times for processing of credential applications, with continued focus on delivery of a helpful high-quality experience for clinicians.
• Manages the CVO credentialing process for clinical providers, in accordance with commercial health plans and CMS Medicare / Medicaid enrollment or government accreditation requirements and standards, Federal and State laws, and Mindful Health Solution policies.
• Coordinates the management the credentialing database ensuring accuracy of data needed.
• Coordinates the management of the electronic credential applications, to ensure distribution, receipt, processing, and timely delivery to commercial or government entities.
• Oversee processes and reviews (including ensuring resolution) all reports related to adverse actions such as sanctions, licensure actions or limitations, and credentialing-related complaints.
• Interview, hire and train new staff on credentialing and recredentialing policies and procedures; also provides ongoing training as needed regarding new guidelines or updated processes / policies to others in the company
• Develops and provides regular reports and presentations concerning the operation and progress of the credentialing functions, including activity related to approvals, denials and / or appeals.
• Create a collaborative, supportive, high-performance, and growth-oriented culture for the credentialing process to ensure patients receive the best possible care as quickly as possible.
Other responsibilities may include:
• Coordinates the management of process to ensure all clinical provider licenses and certificates remain current, ensuring appropriate notification prior to expiration.
• Recommends, and/or implements changes, revisions, and enhancements as appropriate to current credentialing operating environment.
• Provides on-site consultations across MHS with regards to credentialing practices and services; prepares and conducts credentialing orientations and provides updates as appropriate on new policies and procedures.
• Prepares for and coordinates credentialing audits in compliance with delegated credentialing contracts.
• Oversee the supervision of credentialing personnel, which includes work allocation, training, and problem resolution; evaluates performance and motivates employees to achieve peak productivity and performance.
• Oversee and coordinate health plan office site visits. Responds to health plan inquiries, interfaces with internal and external questions on day-to-day credentialing issues.
Skills and Abilities Required
• Strong Project Management skills and experience in this area
• Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies.
• Proven conflict-resolution and critical thinking skills.
• Ability to investigate and analyze information and draw conclusions and quickly arrive at actionable insights.
• Skill in developing policy and procedure documentation.
• Ability to work independently with limited supervision.
• Multi-tasking and knowing how to set priorities.
Qualifications
• Bachelor’s degree in business administration or health care related field preferred.
• Two (2) year experience in a Lead/Management capacity.
• Advanced knowledge of Microsoft Office Software, database administration and other applications.
• 3+ years of healthcare experience in credentialing, compliance, and project management
• In-depth knowledge of provider credentialing regulations, policies, and procedures
• General understanding of medical staff policies, regulations, and bylaws and the legal environment within which they operate.
• Highly preferred but not required certification in one of the following certifications CPES, CPCS, or CPMSM
Pay range: $95,000 to 114,000This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. The employee may be eligible for bonuses and other forms of compensation.
About the company:
Mindful Health Solutions is a premier private psychiatric practice whose purpose is to provide interventional psychiatry and supporting care to alleviate suffering and save lives. As one of the largest interventional psychiatric practices in the U.S., we focus on innovative treatment modalities to achieve our Vision of unleashing the human spirit for generations to come by advancing the science of mental health care.Our expert team of psychiatrists and psychiatric nurse practitioners offers compassionate, high-quality care through a combination of interventional treatments, medication management, and psychotherapy. They are among the most experienced clinicians globally in providing advanced treatments such as Transcranial Magnetic Stimulation (TMS), Esketamine (Spravato), and Ketamine Infusion Therapy, which are highly effective for depression and other acute mental health conditions.